2012 Annual Report: Office of Children’s Comprehensive Mental Health

2012

Annual Report: Office of Children's
Comprehensive Mental Health

CHILD MENTAL HEALTH

Comprehensive System
Management Team

DEPARTMENT OF ELEMENTARY
AND SECONDARY EDUCATION

Division of Special Education

Division of Vocational
Rehabilitation

DEPARTMENT OF HEALTH &
SENIOR SERVICES

DEPARTMENT OF MENTAL
HEALTH

Division of Alcohol and Drug
Abuse

Division of Comprehensive
Psychiatric Services

Division of Developmental
Disabilities

DEPARTMENT OF SOCIAL
SERVICES

Children's Division

Division ofMOHealth Net

Division of Youth Services

DEPARTMENT OF PUBLIC
SAFETY

FAMILY REPRESENTATIVES
FAMILY-RUN ORGANIZATIONS

Families as Advocates
MPACT

NAMI Missouri

FEDERAL GRANT SITE
REPRESENTATIVES

Circle of Hope

Show Me Kids

St. Charles County Partnership
with Families

Youth in Transitions

JUVENILE JUSTICE SYSTEM

OFFICE OF STATE COURT
ADMINISTRATORS

Staffed by
THE OFFICE OF
COMPREHENSIVE CHILD
MENTAL HEALTH

Partnership to Develop a Child Mental Health System

In 2004, the legislature passed House Bill 1003, which sought to create a Comprehensive
Children's Mental Health System to address gaps in the system of mental health services for
children. Missouri statute 530.097 RSMo, established a partnership between the Department
of Mental Health (DMH) and the departments represented on the Children's Services
Commission, including corrections, elementary and secondary education, higher education,
health and senior services, labor and industrial relations, public safety, and social services,
community stakeholders and families.

The partnership was established as the Comprehensive Children's Systems Management Team
(CSMT). Implementation of the system was originally guided by the "2004 Comprehensive
Children's Mental Health Five Year Plan". The plan can be viewed by visiting:
http://www.dmh.missouri.gov/diroffice/depdir/childsvcs/Final%20CCMHP.pdf . The Five Year
Plan ended in 2010 and in the fall of 2011 the CSMT completed a strategic planning session to
set goals through 2013.

In 2005, the Office of Comprehensive Children's Mental Health (Children's Office) was
established through Section 530.1000 RSMo within the DMH to lead the development of the
Comprehensive Children's Mental Health System. The Children's Office staffs the
Comprehensive System Management Team (CSMT) and the Stakeholders Advisory Group (SAG)
that lead the system development. The Children's Office also coordinates system consultation
to the Other child-serving departments that are part of the Children's Services Commission.

This 2012 report summarizes the work of the Children's Office and other related programs in the
Divisions of Behavioral Health and Developmental Disabilities. The report also includes status
updates for the Comprehensive Children's Mental Health System also known as the "System of
Care" (SOC).

Performance and Significant Events of 2012

Infrastructure Enhancements

Throughout 2012, the Children's Office sought to develop and enhance the infrastructure of the Comprehensive
Children's Mental Health System. The following initiatives contributed to building infrastructure.

Comprehensive System Management Team (CSMT) - Accomplishments

❖ Sponsored the first statewide SOC conference linking system of care with public health. Directors from the
Departments of Corrections, Mental Health, Social Services and Health & Senior Services spoke at the
conference of more than 110 attendees. This conference connected Show Me Bright Futures (SMBF) teams that
use the public health approach with local SOC teams and their work. The purpose of this linkage was to help
SOC teams expand their focus from just treatment to the whole continuum of care and to assist SMBF teams
establish sanctioned SOC teams;

❖ Ensured sustainability of the SMBF teams and work by creating a Public Health Committee under the CSMT
umbrella;

❖ Continued connecting the SOC state initiative with the Early Childhood Comprehensive System (ECCS) state
initiative;

❖ Implemented the strategic plan for 2012-2013 and integrated the work of the Local Liaison Committee, SAG and
SOC Work Group (SOC WG). The first three goals of the new strategic plan are currently underway.

❖ Secured funding for local teams to access stipends for family members to participate on teams;

❖ Provided technical assistance to seven SOC and/or inter-agency teams through a regional training in Poplar Bluff;

❖ Offered ongoing technical assistance to all sanctioned SOC teams and SMBF teams following goals and action
steps developed by each team at the SOC conference. This included six webinars on topics identified by teams as
areas of needed assistance.

Stakeholder Advisory Group (SAG) - Highlights

The SAG continued to review the work of the CSMT and provide valuable input throughout 2012.

❖ Provided family representation to the SOC WG;

❖ Reviewed and provided quarterly feedback regarding the work products developed by the CSMT/SOC WG to
advance and improve mental health services for youth;

❖ Worked in concert with DMH staff to coordinate with the Comprehensive Psychiatric Services (CPS) Statewide
Advisory Council (SAC) and other advisory groups.

❖ The SAG expanded their membership by adding three new community members. The SAG continues to recruit
new members, primarily focusing on family and youth members.

State System of Care Work Group (SOC WG) -

The SOC WG was formed in 2011 as a 6 month pilot project under the direction of the CSMT to work on three target
areas: SOC expansion, SOC tools, and enhanced familyengagement/recruitment. The CSMT voted to maintain the SOC
WG permanently in January of 2012.

❖ Membership for SOC WG was recruited to represent family members and providers statewide who were from
local SOC teams and in a position to support these efforts.

❖ The SOC WG has completed the family orientation manual for the SOC web site, the presentation for teams
interested in becoming a sanctioned SOC team and started work on new goals from the CSMT strategic plan.

❖ Several SOC WG members assisted with planning and implementation of the SOC conference and several have
given presentations to unsanctioned teams along with the SOC Coordinator and local liaison members of the
CSMT

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Expansion of Sanctioned SOC Sites -

❖ The three SMBF sites, Rolla, Joplin, and Moberly, have requested presentations and technical assistance in
developing SOC teams in their areas. Rolla invited 27 stakeholders to the presentation developed by the SOC
WG in November. They are actively pursuing the development of a local team.

❖ Several local interagency teams and counties have requested technical assistance regarding establishing a
sanctioned SOC team. As a result, presentations about establishing sanctioned teams are scheduled in Osage
and Gasconade counties, the southeast region and Buchannan county. Technical assistance is ongoing.

Support for SOC Sanctioned Sites -

❖ The Local Liaison Committee (LLC) of the CSMT provided technical assistance to several local SOC teams in 2012.
In response to a request for assistance from Stoddard and Dunklin counties, training was developed for seven
teams. The training was funded by the "Fostering Court Improvement Program" (Office of State Courts
Administrator).

❖ All 14 sanctioned teams plus three SMBF teams were invited to the statewide SOC conference.- "Expanding the
View; Linking System of Care and Public l-lealtli". SOC teams (11) and SMBF teams (3) and other stakeholders
attended this conference in September. Conference sessions included team development, goal setting and
action planning.

❖ Evaluators, Dr. Ed Morris and Dr. Melissa Maras, presented at the conference and provided a post conference
evaluation and follow up work. The data gathered from working sessions was used to identify themes directed
towards follow up technical assistance to local teams, as well as areas for the CSMT to address. All teams have
been contacted and offered specific follow up assistance based on their input. Six webinars were conducted this
fall in direct response to the evaluation data and will be posted on the SOC website as a resource.

Ensure Family Participation -

Local System of Care Teams are strongly encouraged to invite and support family members and youth to participate in
their meetings and activities at all levels. Their expertise, both as parents and as participants, in services is valued and
needed. The SOC teams have been provided resource information related to providing support in the form of stipends
and/or expense reimbursement. Limited funding was secured and set up for local teams to access to provide stipends to
family and youth that participate on local sanctioned SOC teams during 2013.

Show Me Bright Futures (SMBF) -

SMBF was a mental health transformation initiative managed by a state-level interagency team. This team engaged
communities to implement a public health model to prevent mental illness and plan for the healthy physical, social, and
emotional development of children. Three Missouri communities comprised the pilot sites - Moberly, Rolla, and Joplin -
and were in the last year of a three-year project to implement SMBF using a $300,000 grant awarded by the Missouri
Foundation for Health (MFH). The funding ended on November 30, 2012.

The SMBF project was highly successful. A number of achievements were attained and the project has a strong
likelihood of expansion with the infusion of additional resources. The final team evaluations revealed overall progress on
the Think-Plan-Do continuum for teams overall and across most components from 2010-2012.

The SMBF interagency team planned for sustaining efforts of the leadership structure for the statewide SMBF effort by
connecting with the Comprehensive System Management Team (CSMT). The SMBF state management team formally
connected with the CSMT in 2012. It was agreed that the SMBF public health approach efforts should be integrated with
the SB 1003 Comprehensive Children's Plan (CSMT) and the System of Care (SOC).

The formal creation of the Public Health Committee under the CSMT ensures the Department of Mental Health-
Children's Office continued commitment to support a comprehensive children's mental health system of care built on a
foundation of the public health approach. The investment by the Children's Trust Fund to provide training and technical
assistance dollars provides a promising opportunity to expand and connect current efforts of SOC and SMBF. Children's

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Trust Fund support will help the SOC and SMBF teams expand in scope and number to accomplish goals and to sustain
the work. The September 2012 SOC conference included representatives from eleven SOC teams from around the state
and the three SMBF pilot sites. More than 110 people attended and the overall conference evaluation rating was 4.55 on
a five point scale

Missouri Youth REACCH - (Responding through Empowerment and Action to Create Communities of Hope)
Members of MO Youth REACCH are no longer meeting at the state level. The group was challenged because of
transportation issues that occurred when trying to meet in the central region of the state. The group made the decision
to discontinue meeting in Jefferson City and start finding ways to become more active in their local/regional area.

Services and Support Initiatives

SOC Team National Award -

The National Institute for Trauma and Loss in Children' chose Circle of Hope (SAMHSA grantee for a SOC initiative in St.
Joseph) as the "2012 National Agency of the Year". Circle of Hope was selected primarily due to the large number of
community members trained in trauma, the ongoing sustainability built into the training and demonstrating how
becoming "trauma informed" can work successfully within a System of Care team.

Family Support Provider -

The Family Support Provider (FSP) is a Peer Support Service provided by a trained family member/caregiver. This service
is available to family members/caregivers who have children/youth in CPR services at the Community Mental Health
Center's. The DMH has continued to train family members as family support providers in 2012. A strong emphasis was
placed on providing support and assistance to the cadre of existing FSP's.

Transition Age Youth -

Four years ago the DMH received a federal Substance Abuse and Mental Health Services Administration (SAMHSA) grant,
"Healthy Transitions Initiative", to be implemented as a demonstration site in four community mental health centers in
Jackson County. The grant addresses transition-age youth with severe emotional disturbance. The agencies are using an
implementation model and an evidence-based practice, TIP, Transition to Independence Process. They focus on youth
who are between the ages of 16-25 to promote successful functioning in multiple life domains. A local coordinating
council representing community partners promotes a systems approach to seamless service delivery. A state level team,
required by the grant, works to address state level policy issues across departments concerning this age group and plan
for replication across the state.

Early Childhood -

DMH participates on the Early Childhood Comprehensive Systems (ECCS) State Steering Team and attended the ECCS
Summit. In addition, the DMH is represented on the state steering committee for "Maternal, Infant and Early Childhood
Home Visiting Program," a federal grant received by the Department of Health and Senior Services (DHSS) to assure
high-quality home visiting programs for at-risk families. As part of the steering team assistance was provided in applying
for two federal grants for funding for home visitation for families at risk. Six home visiting programs were reviewed as
candidates for promising practice as part of this grant process.

Children with Co-Occurring Issues -

A pilot project was launched creating a partnership between Senate Bill 40 Boards and Community Mental Health
Centers to develop local integrated treatment models for children with co-occurring issues. Phase I counties include
Jefferson, Greene, Boone, St. Charles, Lafayette, Pike and Audrain. Two trainings by national experts were organized by
the St. Charles and Pike/Audrain partnerships

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Child Abuse and Neglect Prevention -

A DMH representative participated in a strategic planning meeting in tiie fall for the Missouri Prevention Partners (MPP)
and served as Vice Chair for MPP during 2012. This is a multi-agency collaborative and work continues with MPP to
develop a plan for ongoing collaborative efforts among child serving agencies. In addition, Missouri Kids First Pinwheels
for Prevention and Advocacy Day at the Capitol was supported on the SOC website and with participation. Assistance
was provided to review grant proposals received by Children's Trust Fund.

Stakeholders Education

Mental Health First Aid (MHFA) -

MHFA is a 12-hour course that educates participants about mental disorders and teaches first-response techniques used
with persons who may be experiencing a mental health-related crisis. The Children's Office serves on the MHFA Advisory
Board. Three staff and one family member were sent to a training of trainers. The Mental Health First Aid for Adults
working with Youth curriculum was completed. Missouri was chosen as the first national training pilot site for
this training.

System of Care Website -

The statewide SOC website stays updated and new pages have been added for partners and child serving agency
initiatives. Marketing and education was conducted to drive audiences to the site. It serves as a clearinghouse
for resources and information of interest to all audiences within the stakeholder community, including families,
youth, providers, agencies and schools; www. m o syste m of ca re . co m .

2012 Spring Institute -

The Children's Office coordinated the development of six workshops on the children's track at the annual DMH Spring
Training Institute. The track topics were:

> Children at Risk: Drug Endangered Children in Our Communities, Shannon Stokes

> Understanding the Importance of Early Emotional Development, Judith Saurage, LPC, Sanaria Sulaiman

> DBTCase Conceptualization, Ryan Lindsay

> Youth Suicide Prevention: Paying Attention to Other High Risk Behaviors, Monica Matthieu, PhD

> Reactive Attachment Disorder, Patsy Carter, PhD

> System of Care: Coordinating and Collaborating at the Local Level, Katrina Harper, Ghada Sultani
Children's Mental Health Day -

"Children's Mental Health Day" is an annual national celebration that started in Missouri two decades ago as a
partnership between DMH and the Missouri Statewide Parent Advisory Network. In 2012 promotional materials
were widely distributed for the May celebration of "Child Mental Health Week". DMH provided support and
participated in various celebratory activities around the state. Statewide activities were tracked and promoted
and the SOC website featured resources, tool kits and articles. A newsletter highlighting the celebrations was
produced and sent out.

Summary

2012 was a year of reorganization, changes, positive outcomes and momentum. The Expanding the View:
Linking System of Care and Public Health conference was the impetus for statewide inertia among system of
care and bright futures teams, widespread technical assistance and interest among many new counties to seek
sanctioned status. Data obtained will inform future planning among the state and local teams and result in
expansion of system of care. Local teams are in the process working on goals and action steps developed
during this conference and technical assistance and resources are being developed by the state team and SOC
Work Group.

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A new initiative to linl< the public health approach, community behavioral wellness and system of care teams
was developed and will be monitored by the Public Health Committee. The Show Me Bright Futures initiative
will be sustained under the guidance of the CSMT and also monitored by the Public Health Committee.

An exciting pilot project was launched that created a partnership between Senate Bill 40 Boards and
Community Mental Health Centers to develop local integrated treatment models for children with co-occurring
issues. Seven sites are involved in the pilot phase.

One federally funded local system of care site, Circle of Hope was the recipient of a national award, "2012
National Agency of the Year," for their exceptional work establishing trauma informed care in their area.

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